Safe SSRI with heart meds

[Djmoore]

My husband has atrial fibralation and is taking Tikosyn, Eliquis, Carvedilol, And Tamsulosin.  He has recently been diagnosed with GAD,  what SSRI can he take safely with his other meds to help with anxiety and depression, anxiety is a big problem.  

[tom_h]

I can't comment on the drug interaction of SSRI's and SNRI's with heart meds.  But I'd want to say that you should consider each very carefully before starting either family of drugs.  My wife was on Paxil (Alprazolam) for many years before switching to the SNRI Effexor (Venlafaxine) following treatment for breast cancer.  It was found that SSRIs interfered with the Tamoxifen that she was taking.  Both drugs have serious withdrawal symptoms if stopped for any reason, and it can show up within as little as 24 hours from ceasing the medication.  I've seen these symptoms in my wife when she was ill and unable to hold food or her meds down.  It is not pleasant.

Coincidentally, just last week, she decided that she had  had enough of the Effexor, and switched back to Paxil.  She immediately began to experience the common "brain zaps", nausea and headaches felt when stopping Effexor, but the Paxil really helped to ease the severity of the symptoms.  10 days later, the brain zaps are gone, but the nausea and headaches continue, especially when her daily dose of Paxil is about due.

She is a different person on the Paxil and says she feels fantastic.  But I'd consider what you're getting into before starting either one, as once on them, getting off of them in the future is a long, slow process to trick your body into living with less and less over time.

[is_something_wrong]

SSRIs often interact with the metabolism of lots of medications. Paroxetine (Paxil), Fluoxetine (Prozac) and Citalopram/Escitalopram (Celexa, Lexapro) are inhibitors of CYP2D6 - the enzyme responsible for metabolizing lots of medications. Fluvoxamine (Luvox) is inhibiting another enzyme.

Sertraline (Zoloft) do not have this side effect, and Venlafaxine (Effexor, a SNRI) is also perhaps a good choice, as itdood said.

Citalopram and Escitalopram are both prolonging the cardiac repolarization and they are usually not recommended with arrhythmias. But your question is hard to answer and I would recommend asking your doctor or pharmacist.

[itdood]

That's a tough question for us common folk. Someone could run his list of meds through a pharmacie program to get a list of interactions.   You could also look into SNRIs too, not just ssris.   I have gad and couldn't get on SSRIs, they made it worse.  Everyone is different with these.    Then we tried an Snri and it worked awesome.  The one I was on, as a side effect, blocks a critical liver enzyme, so it interacts with just about every medication out there, doubling its half life.  I wasn't on any other meds so it was doable.

These meds all have different trade offs and results, so you have to experiment until you get the right one.   So I would get a list of compatible SSRIs and SNRIs and start trying them.   SSRIs can take up to 6 weeks to see a result.  I had full results in 2 weeks with the SNRI I was on, it's called Nefazadone.